Skip to main content

tv   [untitled]    May 29, 2015 12:00am-12:31am PDT

12:00 am
the commission will please come to order and the second will call the roll. >> commissioner patting, singer, chow, commissioner chung, present, commissioner cash mer. the next item is minutes to approve. >> the commission minutes are in order. any questions. all in favor say, "aye". >> aye. >> any opposed? >> next item. >> item 3. directors report. >> good afternoon commissioners. the state and governor brown released an updated fiscal year 15-16 state budget proposal on may 14, 2015. which provides $140.5 billion for
12:01 am
health and human services and included allocation in the governor's january budget. while funding includes proposal that could increase access to medical. the may revision does not make significant adjustments to public health funding and renewal or medical providers rates. it is expected to have a neutral impact and legislation will hold another meeting to finalize the budget in mid-june. >> i wanted to nouns a -- announce a proposal to include $6 million to provide on going support for respite beds for chronic medical needs. this residue pit program will include a program for clients that cannot
12:02 am
be adequately served in the homeless shelter system for individuals who amide be otherwise on the street using emergency services. this expansion of medical respite is the next step of series for solutions to the city's homeless population and to provide needed mental health and services and getting homeless individuals the support they need earlier and helping to avoid crisis that can cause harm and great expense. also included in the $28 million proposal that the mayor released last week $14.5 million to bring 5 occupancy buildings for the housing masterpiece portfolio for a 45 bed hotel. $1.8 million new funding to increase site sefrtsdz services at the
12:03 am
sro units and $3 million for the mission district. the department provides all the medical mental health for referral services and hot teams identifying people in encampments and will have an important flow to permanent housing. this last week, supervisor avalos sponsored a recent hearing at city hall on staffing levels and systems at san francisco hospital and gph clinics and opening the new hospital and participation in aca and human resources director reviewed in may of last year during the supervisor's hearing. we also provided key
12:04 am
information for the lean process, the reduction of the temporary use of employees and the development of metrics to measure performance and partner with the city and county of the san francisco human resources. i believe the hearing went went. there are still questions being asked, but i think we showed a significant improvement in our hiring process and we'll continue to work particularly with the unions who have questions about the staffing levels in areas of the department. i will leave the report at that unless there are other questions regarding the other directors report and the addendum i presented. >> thank you, commissioner patting? >> just a request about the navigation center. if we could maybe arrange a tour, whatever will be at your convenience. this is great for the city and health consequences and interested in learning more about it. or
12:05 am
if you don't want to do the virtual tour, with pictures and slides might even suffice. >> absolutely. we'll welcome that and it takes a little bit of alternative route from our existing shelters. one they can come and go. there is a time period that you have to be in by 10. you can bring your belongings. couples are welcome. they are trying to create a new program looking at the barriers for people who are accepted in the shelters and enhancement of everything brought into the center. we'll be able to stay at that location for another year. i know ben and duffy are looking at other locations. this really does i think the funding that they are receiving will solidify this program and we are hoping to duplicate it in other parts of the city. we
12:06 am
will arrange an invitation for anyone who would like to come. >> i looked at the powerpoint presentation for the board of supervisors committee was extremely well done. very succinct and very pleased to hear it received a good reception. >> yes. a lot of staff have participated in the development of that. >> it's kind of unfortunate the governor's budget while expanding medi-cal did not talk about expanding provider reimbursement? >> we believe that may come up in the june revise of that. we are still expecting to see that. >> our city's position is to ask for more? >> definitely. >> because we are no. -- in
12:07 am
reimbursement for medi-cal and medicaid. our schedule for provider services is the last in all 50 states. and yet we are expanding services. so that's been the whole argument about whether or not we actually will have capacity as we expand accessibility. any further questions to the director, if not, then we'll go on to the next item. >> item 4, general public comment. i have not received. looks like we are going to have. i believe we have a comment. mr. patrelis. you are the only public comment on this item.
12:08 am
>> hi. michael patrelis, a person living with aid. my health is in danger because of lack of bathrooms. there was a story about a shagella outbreak. a fancy word for diarrhea among the homeless population here. this story scared me because the homeless people do not have places to pee and poop and they do it on the street and they have no place to wash up. so they have done their business, their hands are dirty, probably infected and that's how they passed it among themselves and when they touch a railing on muni or other public space, they are putting others at risk, too 3 months ago today
12:09 am
i received an e-mail from duffy asking about opening the toilets and fire houses so more homeless people and the public could have public places to pee and poop without creating a horrible insanitiary condition and she told me she would get back to me and it's been 3 months later and i have still nod -- not heard. this is not okay. we need you to address not only the lack of public bathrooms but places to shower. i don't want you to change what's going on right now but on the first floor, there is a homeless guy using that bathroom on the first floor here to wash up. the lack of public
12:10 am
facilities for homeless to keep sanitary is under your noses. you can go down the alleyway and inhale the pee and poop. what is it going to take that we have a shagella outbreak on the chronicle. the homeless people are using this facility here because they have to go through the security things. go into any public library. the homeless if they are lucky they are using the toilets to wash their feet and the rest of their bodies. on top of all that, i really think that everyone with a compromised immune system in san francisco needs to get in touch with the right people and look at opening these public toilets and showers at the fire
12:11 am
department. thank you. >> thank you. >> that's the only public comment that i know of. >> thank you. >> the next item on the agenda is the report back from the public health committee. >> the community on public health heard two things today. about child maltreatment in san francisco. children suffered for child maltreatment. that's what we know. we think problem is much larger. the child maltreatment is related to substance abuse, mental health and a lot of other health conditions. it really as we looked at it, the impact of child
12:12 am
maltreatment was amazing. but fortunately our department of public health is doing an excellent job. we have a very short window. one was a collective impact projects in this area and falls in the area of maternal child health and including nurse family practitioner which are doing home visits for families at risk. one of the highlights was visiting 170 families mostly single teen mom's that were identified at risk and some of the improvements shown specific intervention efforts and to address child maltreatment. kudos to the department and to our paternal child health team. the second report
12:13 am
was on opiate use and dr. robinson on the treatment of opiate dependence which is a merging epidemic in san francisco and the state. san francisco is ahead of the curve. we have novel programs like methadone vans. opiate treatment integrated throughout primary care. if there is a cutting age for opiate treatment in san francisco including the use of needle exchange. and this is also ground zero for over doses. the department has done and excellent job on both of these issues and proud to hear their reports. >> thank you. questions? if not, we'll proceed on to the next item, please. >> commissioners item of of --
12:14 am
6 resolution requesting sale and retention of the proceeds of all stocks in the laguna honda hospital resident gift fund. >> good afternoon, as you know laguna honda fund is a way for the hospital to receive donations on behalf of it's patients. from time to time we have received funds in the form of gift certificates as stock. under the code of the treasurer's office is responsible for sale and disposition of stock and other assets so we've been working with the treasurer's office on a path forward to sell those stocks and deposit to the laguna honda fund. we have before you a resolution
12:15 am
that would be directing the treasurer's office to make that transaction and deposit to the gift fund and working with our staff, a list of target sales price to not execute the transaction. if we go forward with the sale of this stock, we'll have recognized significant amount of appreciation to the total value of those stocks for the benefits of the patients. so, i'm happy to answer any questions. we have the treasurer's office here to answer any questions. >> commissioners? questions before we accept the resolution. commissioner singer? >> i have one minor question. if we are going to sell it, we should sell it at
12:16 am
market and why 11% discount. >> absolutely we will sell it at market and we'll get the best price we can. the purpose of that second column is essentially to indicate that if by some chance the market changes prior to the point that we execute the sale and the market value dips below that price, we will not sell it below that price. that will be the minimum that we will sell it for. we expect it to be higher for that minimum because of the value. >> so maybe for information purposes if you can come back to us when it's done with a column that says this is the price we sold it at. >> absolutely. >> great. >> in the overall approximate price of the portfolio? >> a little over $1 million is the expected income from the sale so that will be appreciation from the initial value of the gift that is
12:17 am
$400-500,000. >> there is someone who would like to make a public comment on this item. a slip wasn't turned in but the gentleman made the question. >> okay public comment on the subject which is 3 minutes. >> thank you. the proposed sale on gift on stocks should have been disclosed at the laguna conference committee in march. instead cfo and ceo michael acrossey withheld the information which they knew about a week before. the city treasurer's investment team was way more forthcoming granting an interview and answering all of our questions. at
12:18 am
least the treasury officials are trustworthy. now some of the gift fund stocks are ethically problematic for the health department. you own shares in war profit ears. boeing, hall burton and general electric. you support major pollute ors. exxon, chevron, bp and dupont. and coca-cola. so divesting in these stocks is appropriate. fortunately the loss of dividends which will occur will be offset by a new be quest to the gift fund. one of my
12:19 am
former colleagues the late dr. millka rolls bequeathed $500 million to honda. so it's okay as long as we monitor what laguna honda does with all that money. thank you. >> thank you. we have one more public comment on this subject. mr. patrelis? >> michael patrelis, again. i would like to endorse what he just said. i have known him for the sunshine advocate and community advocate regarding laguna honda. i'm aware of what you have been discussing
12:20 am
here today and have concerns about monitoring what you are about to do and the $500000 coming to you. i think that you really have to listen to what he is saying and heed his advice. thank you. >> thank you, any further public comment? >> no more public comment request. >> thank you, commissioners? any questions to the presenters or otherwise we are prepared to have a motion to place the resolution as our business. >> so moved. >> there is a motion for that. is there a second? >> second. >> the resolution does direct that proceeds will be retained in the resident fund and therefore will be monitored in the usual way, is that correct? >> that's correct. >> thank you. so the resolution is before
12:21 am
you. is there further discussion on the resolution, if not we are prepared for the vote. all in favor say, "aye". >> aye. >> any opposed? the resolution is passed. thank you very much. >> commissioners item 7 proposition q hearing closure of skilled nursing facility beds at st. mary's medical center. good afternoon, commissioners. i'm health planner with the the office of policy planning at dph. i'm
12:22 am
here to provide you with additional information as a follow up to your last hearing on proposition q regarding the reduction of skilled nursing beds at st. mary's medical center. >> can you speak up a little louder because your voice is not carrying. >> okay. >> so at the last meeting the commission requested information on the breakdown of short and long-term beds in skilled nursing facilities in san francisco. california license and skilled nursing beds the same regardless of whether they are short-term and long-term beds. in order to get short-term and long-term beds we used facilities. short-term is defined less than 3 months and long-term is greater than 3 months.
12:23 am
so, san francisco is estimated to have 1340 skilled nursing beds and the majority are long-term beds located at jewish home at laguna honda hospital. represents 62% of hospital bedded and 72% long-term beds. >> the total number of skilled nursing beds within freestanding facilities is 1131. we do not have data that breaks down the long-term and short-term. we used data that we had from the state. what we did was we took the percentages of the discharges that were occurring within 3 months or less and multiplied that by the total anybody of
12:24 am
licensed beds. based on this estimate we would have 704 short-term beds and 427 long-term beds. the 85% of all of the discharges are occurring within 3 months or less. about 50% of discharges are going home, 25% are rehospitalized. 8% are transitioned to another facility and 9% are patients who are dying. finally the occupancy rate is 89% which is higher than the state indicating that we have less room for expansion in the face of growing need. so, this table provides the total number of estimated short and long-term skilled nursing beds in san francisco as projected by 2020. 41% of skilled
12:25 am
nursing beds are estimated to be short-term and 59% estimated to be long-term totaling 3771. all of the short-term beds are located in freestanding facilities and the long-term in hospital bed facilities. these projections are based on known cuts that we have for hospital based facilities and skilled nursing facility beds will remain stable over the next few years. in terms of the potential impact of skilled nursing bed reductions, changing demographics namely our aging population as well as reduction in skilled nursing services may create a capacity risk in san francisco.
12:26 am
san francisco already has a high percentage of seniors and adults that are disabled that require assistance in the community. 30% of seniors live alone in san francisco and this may impact the need for the occupancy of short and long-term beds as patients are not able to return home without proper care giver support and the majority are family members. skilled based nursing facilities have a high occupancy rate. care delivery is continuing to evolve and financial incentives don't necessarily align with some form of institutional care. we also know current trend is shifting towards home and community base care however the hospital base nursing care without the investment may result in unmet
12:27 am
care needs for the community. for example, we know that hospitals often delay discharges for a patient who can't safely discharge home and often affected by program wait list and for evaluation of services. this will lead patients at risk for at risk events while they are waiting. ultimately highlighting the fact that an investment in community services and transitional care is critical to compensate for the lack of skilled nursing facility resources in the community. thank you. >> commissioners, any questions to the department's presentation?
12:28 am
>> thank you. is there any public comment on this? >> i have not received any public comment request on this item. >> okay. commissioners, we have before us a draft resolution, several draft resolutions and the final one that is proposed has language that speaks to the issue of the short-term beds being defined. we don't have as we talked about earlier what is actually the number of short-term beds that we should have versus long-term beds as versus to opposed to acute care. in background, if we look back on the commission and that's my role as you are a senior member the sniff
12:29 am
issue and sniff closures have been going on since 2007. at which time we have almost identical issues that arise. in 2007, saint frances closed their sniff beds. it's interesting that comments were very close to the comments we are now receiving for st. mary's for the same reason. we had the discussion with the system and again those were the closures of short terms snp beds. at that time sutter indicated that they were scaling down to the number of snp beds that they needed within their system and there would be capacity outside for aside from their system. we are aware that our own
12:30 am
hospital, san francisco general has snp beds for the reason of post acute care and the reason that we discussed before us as to why short-term snp's are needed as part of a transition and continuum of care. we've also heard that chinese was going to put in a number of snp beds but their projection is based on what they need for their system. this is kind what if we know. but there is a number that we don't know. which is in the change ing environment and the increase of the availability for people to have insurance and be able to place into the correct level of care what level of care should people be and how would they access certain services. is that with the additional services that are available